Understanding Male Infertility: Symptoms, Causes, and Treatments

by Brynna Connor MD | Jun 23, 2023 | infertility, reproductive health, Sexual Health, sperm

Are you trying to have children but finding it difficult? Although not many people openly talk about it, infertility is a common issue. Nearly one out of ten men experience the condition.

Male infertility can have multiple causes. Your doctor can help you identify some of the reasons you may be struggling to conceive. Depending on the cause of your fertility issues, there are multiple available treatments that may help, including hormone therapy, medication, surgery, and assisted reproductive technology.

What Is Male Infertility?

Pregnancy doesn’t always happen right away. However, when a couple has unprotected sexual intercourse on a regular basis for at least a year and they don’t conceive a child, experts say that they are infertile.

If your partner is under the age of 35 and you have been trying to achieve pregnancy for a year or more, it may be time to talk to a doctor. If your partner is 35 or older, you may want to see a doctor after six months of trying.

Infertility is often not accompanied by any other signs other than being unable to conceive a child. However, in some cases male infertility exists alongside other symptoms that may point to an underlying health condition. These may include:

Erectile dysfunction
Low sex drive
Problems with ejaculation
Pain or swelling in the testicles
Loss of smell
Gynecomastia (growth of breast tissue)
Loss of facial or body hair
Frequent respiratory infections

If you have any of these signs or symptoms, talk to your doctor. They may help your doctor understand which tests to run to determine the cause of your infertility.

Potential Causes of Infertility

Infertility can be affected by health problems that affect either person within a couple. About 20% of infertility cases are solely caused by health issues that affect men, while 30-40% of cases result from conditions in both partners.

There are several steps involved in creating a pregnancy. Sperm is made by the testicles and released into the vagina during sexual intercourse. This process may be disrupted if the testicles can’t produce enough sperm, the sperm cells aren’t healthy, or if there are problems releasing the sperm.

Underlying causes of male infertility include a variety of medical disorders and medications. The cause of infertility is unclear for about half of men.

Conditions That Affect the Testicles

Several disorders can prevent the testicles from making enough sperm, or can make the sperm appear abnormal. These include:

Varicocele, a condition that leads to enlarged veins in the testicle and is found in 40% of men with infertility
Testicle injuries
Diabetes
Certain autoimmune disorders
Infections such as tuberculosis, urinary tract infections (UTIs), sexually transmitted infections (STIs), or fungal infections
Cystic fibrosis

Some medications and substances, including cancer treatments, alcohol, tobacco, cannabinoids, opioids, steroids, and illicit drugs, can also affect the function of the testicles. Additionally, exposure to chemicals like insecticides or pesticides may decrease sperm count.

Hormone Imbalances

The hypothalamus and pituitary glands make hormones such as prolactin that “tell” the testicles to make sperm. When these organs don’t work properly, hormone levels may become too high or too low and sperm counts may decrease.

Conditions that lead to hormone imbalances include Cushing syndrome, iron overload, head injuries, tumors, or genetic conditions like Prader Willi syndrome or congenital adrenal hyperplasia. Your hormone levels may also change if you undergo radiation treatments or take testosterone supplements.

Genetic Conditions

Disorders that are caused by genes passed down through families can also lead to infertility. These conditions include Klinefelter’s syndrome, Kallman syndrome, myotonic dystrophy, and Y-chromosome microdeletion.

Infertility Risk Factors in Men

Some men may be more likely to experience infertility than others. You are at greater risk for this condition if you:

Are at least 40 years old
Smoke cigarettes
Drink heavily
Use drugs, including marijuana or opioids
Are overweight
Use medications containing testosterone or similar substances in order to treat health conditions or build muscle
Have used certain types of medications, such as diuretics (water pills) or ketoconazole (an antifungal medication)

How Are Male Infertility Issues Diagnosed?

If you are having problems with your fertility, your doctor may want to run several tests in order to diagnose or rule out different potential causes.

Your doctor will likely start with a basic physical examination, which may involve checking for problems such as swelling of the prostate (a gland located in the groin), a hernia, or a mass in the testicles. Your doctor may also ask you questions about potential related symptoms such as fevers, a low sex drive, or injuries to the groin.

It may also be a good idea to undergo hormone testing to measure the levels of hormones like testosterone, prolactin, or thyroid hormones that may be affecting your fertility. In some cases, your doctor may also recommend undergoing genetic testing or a testicular biopsy (removal of a small piece of testicle tissue for further examination).

A common part of diagnosing male infertility issues is semen analysis — testing to measure sperm health. Semen analysis involves measuring three key factors:

Concentration — How many sperm cells are found within a certain amount of semen
Motility — How well the sperm are able to move
Morphology — Whether the sperm cells are shaped normally

Semen analysis may also look at other factors, such as how much semen is being produced and how many white blood cells are found in the semen. These results can all help point to possible causes of infertility.

Male Infertility Treatments

The fertility treatments that work best for you depend on the underlying causes of your infertility, your partner’s age, how long you have been infertile as a couple, and your personal preferences.

In some cases, infertile couples can still get pregnant without treatment. Pregnancies happen in about 23% of infertile couples within two years, and 33% after four years. However, making lifestyle changes, taking medications, or undergoing procedures may increase your chances of conceiving.

Lifestyle Changes

Whether or not you undergo other infertility treatments, building up or changing certain habits can improve your sexual health and may help relieve infertility problems. You may want to try:

Quitting smoking cigarettes or using tobacco products
Stopping using marijuana or other recreational drugs
Reducing how often you drink alcohol, or quitting drinking altogether
Avoiding coming into contact with chemicals like pesticides and heavy metals such as lead and mercury
Getting more physical activity
Eating a balanced diet that provides a wide range of nutrients
Taking antioxidant supplements
Maintaining a healthy weight (both obesity and low body weight may contribute to fertility problems)
Wearing boxers rather than tight-fitting underwear
Avoiding saunas, hot baths, or other things that may increase the temperature of the testicles

You may also want to ask your doctor about any other possible steps that might help improve your fertility. For example, certain medications that you are taking may have side effects that impact sexual health.

Hormone Therapy

Several different hormones produced by the body are important in the creation of new sperm cells. Taking medications that contain human hormones may help treat male infertility, although not all research agrees. Your doctor may recommend taking one or more hormones, such as:

Human chorionic gonadotropin (hCG)
Gonadotropin-releasing hormone (GnRH)
Luteinizing hormone (LH)
Follicle-stimulating hormone (FSH)
Human menopausal gonadotropin (HMG), which is a combination of FSH and LH

Hormone treatments may work best for men experiencing infertility due to low hormone levels. It is less clear whether these therapies can boost fertility for men with normal hormone levels.

Medications for Infertility

Your doctor may also suggest using other medications that work in different ways to affect fertility:

Dopamine agonists can help treat tumors on the pituitary gland that lead to hormone imbalances.
Aromatase inhibitors increase levels of testosterone and reduce levels of estrogen in order to boost how much sperm the body makes.
Selective estrogen receptor modulators (SERMs) restore healthy hormone levels that lead to optimal sperm production.
Antibiotics can treat infections such as prostatitis that may be impacting fertility.

Surgery for Infertility

Surgical procedures can help heal certain anatomical problems. Some surgeries, such as fixing a varicocele, may help the body produce more sperm. Surgery may also help sperm be more effectively delivered during ejaculation. For example, some men may need surgery to reverse a vasectomy or heal a blocked vas deferens (the tube that carries sperm out of the testicles).

Other types of surgery allow doctors to collect sperm directly from the testicles to be used in assisted reproductive technology procedures. This may be useful for men who produce very few healthy sperm or have a problem that prevents sperm cells from reaching the semen.

Assisted Reproductive Technology (ART)

ART consists of several different types of procedures that can assist with overcoming infertility problems. In the U.S., about one out of 50 babies born each year were conceived with ART. Common types of ART include intrauterine insemination and in vitro fertilization.

Intrauterine insemination (IUI) involves collecting a sperm sample and placing it directly into the uterus with a narrow tube. Couples who use IUI may have as much as a one in five chance of becoming pregnant during each cycle, although success rates can vary. IUI may be a good option for men with:

Low sperm counts
Reduced sperm mobility
Erectile dysfunction
Retrograde ejaculation (a condition that results in sperm being delivered backward into the bladder instead of out of the body through the penis)

In vitro fertilization (IVF) is a common form of ART that involves fertilizing egg cells outside of the body and then implanting them into the uterus. It may be helpful for men who have low numbers of healthy sperm or in cases where the sperm is not able to be ejaculated out of the body. IVF involves a couple of steps:

Ovarian stimulation — Medication is used in order to encourage the ovaries to produce multiple egg cells at a time.
Egg retrieval — A needle is used to collect eggs from the ovaries with the help of ultrasound imaging, which helps the doctor visualize where to place the needle.
Fertilization — Sperm cells from a semen sample are incubated with egg cells, or a single sperm cell is injected directly into an egg.
Embryo transfer — Fertilized embryos are delivered into the uterus via a long, thin tube.

Other ART options involve using a third party to get pregnant. For example, you may want to consider sperm donation if you don’t produce sperm or don’t want to pass on genes that may lead to a genetic disease. If you choose this option, your partner may be able to get pregnant with IUI or IVF using a sperm sample from another man.

If your partner doesn’t produce healthy eggs or can’t carry a pregnancy, other third-party-assisted ART procedures may help. You can choose to get an egg donation, in which your doctor can collect donated eggs from another woman, combine them with your sperm, and implant embryos in your partner’s uterus. Additionally, you can get a surrogate, in which another woman carries and gives birth to a pregnancy conceived via IUI or IVF with cells from you and your partner or from donors.

If you are interested in trying any ART options, talk to your doctor or to a fertility specialist. Whether ART is successful depends on multiple factors. The CDC lists success rates for ART procedures for fertility clinics across the country, and offers a calculator that can help estimate how helpful IVF may be based on the characteristics of you and your partner.

Addressing Male Fertility Issues

There are a lot of factors that can affect your fertility. If you and your partner are struggling to get pregnant, your doctor or fertility specialist can help uncover possible problems and recommend treatments that might work best for the needs of you and your partner. Infertility is a common problem, and there are multiple options that may help.

If you are experiencing male fertiliity issues and would like to discuss your personal issue with a physician, make an appointment with Dr. Brynna Connor.

Superfoods for Super Sperm (Part 10 of my Superfoods series)

by Brynna Connor MD | Jan 16, 2023 | diet, hormones, meals, natural remedies, nutrition, other, Sexual Health

Your diet can impact many aspects of well-being and it can be an important aspect in understanding male infertility. You may know that the things you eat affect your physical health and even your mental health, but do you understand how food can influence your sexual health?

Adding superfoods to your diet may be a good way to increase the health of your sperm and boost your fertility. While there’s no scientific definition of what makes up a “superfood,” this label is often given to foods and drinks that contain a lot of vitamins, minerals, and other nutrients that boost health. While superfoods generally can’t cure conditions like fertility, they can be an important part of optimizing your sexual health to be the best it can be.

Why Is Sperm Health Important?

In order to naturally conceive a child, you need to have enough healthy sperm. Sperm are cells made by the testicles in the male reproductive system. They combine with egg cells made by the ovaries in the female reproductive system to result in an embryo. Multiple types of hormones, including testosterone, help control the production of sperm.

There are a few components to sperm health, including:

How many sperm cells your body makes, usually measured by how many sperm cells are found within a certain quantity of semen
The ability of sperm cells to move rapidly
The sperm cells’ shape and size

If your body doesn’t make enough sperm, or if your sperm cells are abnormal, you may have a hard time getting your partner pregnant. When a couple is unable to conceive after at least one year of regular sex, they are said to be infertile. Infertility has multiple causes that can affect men and women, and there are several possible medications, surgical procedures, and lifestyle changes that can help treat this condition.

Boosting Sperm Health Through Superfoods

Men who eat certain superfoods may produce healthier sperm cells and be less likely to experience medical conditions that impact fertility. The more health-boosting superfoods you can add to your diet, the more you can optimize your sexual health.

Oysters

Oysters are a fantastic source of zinc. One serving of this seafood provides 673% of the recommended daily intake of this mineral. You can also find zinc in superfoods like pumpkin seeds, yogurt, chickpeas, and oatmeal.

Zinc is a very important nutrient for fertility in men. Tissue in the prostate gland as well as the fluid portion of semen contains high amounts of zinc. When zinc levels drop too low, your body may make less sperm, or the sperm may be shaped abnormally, die more quickly, or not work properly in order to fertilize an egg cell. Zinc also helps the body make hormones like testosterone. Some cases of male fertility problems have been linked to low levels of zinc within sperm cells.

Oily Fish

Oily or fatty fish like salmon, trout, mackerel, and sardines have a lot of omega-3 fatty acids — molecules that can help fight inflammation and cell damage. Eating more foods that contain this nutrient can help the cell membrane (outer layer) of sperm cells function properly and may boost sperm health.

Omega-3 fatty acids are good for your health in other ways, too, making them a popular choice among people looking to eat more superfoods. For example, these molecules can help boost heart and eye health, reduce symptoms of rheumatoid arthritis, and may protect against conditions like cancer and Alzheimer’s disease.

Additionally, oily fish contain coenzyme Q10 (CoQ10), also called ubiquinone. This molecule is an antioxidant, helping neutralize reactive oxygen species (ROS) — chemicals that can cause damage within cells and tissues. CoQ10 can help prevent ROS from building up in the semen, which helps sperm live longer and stay healthier. CoQ10 may also help the body make additional antioxidants that protect sperm health.

Cod Fish

Cod is a type of whitefish. It’s not an oily or fatty fish that has a lot of omega-3 fatty acids. However, it does contain a lot of carnitine, an amino acid-like molecule that helps cells process fat to be used as fuel.

Sperm cells need a lot of energy in order to be able to swim around more effectively. Carnitine helps supply sperm with the fuel they need for proper movement. It also supports the growth and development of new sperm cells.

Carnitine is also present within animal products such as beef, but too much red meat can be detrimental to your sexual health. Supplements containing carnitine are also available.

Brazil Nuts

Brazil nuts contain a lot of a nutrient called selenium. When your body doesn’t have enough selenium, you may be more likely to have problems with infertility. Like CoQ10, selenium is an antioxidant that gets rid of damaging ROS chemicals that can kill sperm.

Eating more Brazil nuts may help boost your sperm health. Just a one-ounce serving (about 6 to 8 nuts) provides nearly 1000% of your recommended daily intake of selenium! This nutrient can also be found in fish and seafood like tuna, halibut, sardines, and shrimp.

A couple of clinical trials have tested how nuts can impact male fertility. These studies found that men who eat more nuts produce more sperm and have sperm cells that move around better, are shaped more normally, and live longer.

Oatmeal

Oatmeal is a whole grain that provides a large helping of fiber — a type of carbohydrate that provides many beneficial effects for the body. Eating a lot of fiber may reduce levels of estrogen, a hormone that could prevent the body from producing enough sperm. Oats and other grains can lead to healthier sperm and increase the chances that an egg will implant in the uterus after being fertilized by sperm.

Yogurt

Your digestive system contains about 100 trillion microorganisms, including bacteria that help you stay healthy and digest your food. Eating high-fat foods can feed the “bad” bacteria, leading to chronic inflammation, a higher risk of several health conditions, and problems producing healthy sperm.

On the other hand, you may be able to increase the number of “good” bacteria in your gut by eating foods that contain probiotics (live microorganisms), such as yogurt. These foods can help improve your digestive health, which in turn has wide-ranging impacts throughout the body. You can also find probiotics in foods like sauerkraut, kimchi, and kefir.

Organic Fruits and Vegetables

When you eat produce, it may be worthwhile to reach for organic options. Fruits and vegetables are often grown using pesticides and insecticides, and these chemicals can lessen the health of sperm cells.

Foods that are certified organic have to meet certain standards as they are grown and harvested. In particular, organic fruits and vegetables come from plants that have been grown without the use of certain synthetic pesticides and fertilizers. Avoiding these chemicals may lead to higher-quality sperm. Look for the label “USDA Organic” while grocery shopping.

Fruits and vegetables also contain a lot of prebiotics — substances like fiber that can help feed the “good” bacteria in your intestines. Produce like leafy greens, onions, artichokes, and bananas may have particularly high levels of prebiotics.

Furthermore, produce generally contains a lot of antioxidants such as vitamin C, tocopherol, and lycopene that help prevent the early death of sperm cells. Overall, fruits and vegetables work on multiple fronts to help boost sexual health and sperm quality, especially if they are organic.

Diet Plans to Improve Sperm Health

Adding more individual superfoods to your diet may help improve your fertility. However, studies have also found that men who more closely stick to an overall pattern of healthy eating produce more sperm.

Men who follow the Mediterranean diet are more likely to have higher sperm counts and to produce sperm that can move more quickly. The Mediterranean diet is also well-known to provide other health benefits, including lower cholesterol and blood sugar levels and a reduced risk of conditions like heart disease, diabetes, and Alzheimer’s disease. This diet emphasizes:

Using olive oil instead of other fats like butter
Eating more nuts, seeds, and beans
Consuming large amounts of fruits and vegetables
Choosing whole grains or whole wheat products over refined grains
Eating plenty of fish, moderate amounts of chicken, and very little red meat
Drinking moderate amounts of red wine

Another diet plan that has been studied in relation to sperm health is the Prudent diet. Following this diet can boost sperm counts and help the body produce higher-quality sperm. The Prudent diet is a modified version of the Mediterranean diet in which you eat more fish, chicken, vegetables, fruit, beans, and whole grains.

Foods and Drinks To Avoid for Better Sperm Health

Studies show that some foods can lead to poor semen quality. In particular, a western diet can be detrimental to sexual health. Men who struggle with infertility are more likely to eat diets that are high in fat or calories.

In particular, you may want to limit or avoid:

Red meat like beef or lamb
Processed meat such as sausage, hot dogs, bacon, and deli meat
Foods that contain a lot saturated fats or trans fats, including processed foods, fried foods, cheese, and sugary foods and drinks
Caffeine, found in coffee, black tea, and soda

Alcohol can lead to hormone imbalances, including reduced testosterone levels, that lead to lower sperm levels. Men who drink heavily may be especially more likely to experience fertility problems. Infertility treatments such as in vitro fertilization (IVF) also tend to be less successful when men drink in the week leading up to giving a sperm sample.Some people believe that soybeans and soy products such as tofu can negatively impact male fertility. This is because soy contains molecules called phytoestrogens that are similar to the estrogen hormone made by the body. High levels of estrogen can lead to lower sperm counts. However, studies have found that men who eat moderate amounts of soy aren’t more likely to have unhealthy sperm, low testosterone levels, or other infertility problems. In fact, at least one study has found that eating some soy can actually lead to higher-quality sperm, so there is no reason for men to avoid soy-based foods.

Lifestyle Changes for Sperm Health

In addition to following a diet that provides your body with a wide range of nutrients, you can make other lifestyle changes that can boost your sexual health.

Some studies have found that physical activity can help boost sperm counts and sperm health. Likewise, men who spend more time watching television and those who lead sedentary lifestyles are more likely to produce less sperm.

Smoking cigarettes can also reduce sperm health, so quitting tobacco products may help improve infertility problems. Additionally, marijuana and other recreational drugs can prevent the body from making healthy sperm and can impact sexual health.

Changing your daily routine by eating more superfoods or creating other health-building habits can increase your sperm health. However, if you continue to struggle with infertility, your doctor can help you learn more about potential causes and recommend treatments that may increase your chances of conceiving.

If you are planning a family and would like to consult with Dr. Connor, please make an appointment.

Treatments for Erectile Dysfunction

by Brynna Connor MD | Sep 29, 2022 | natural remedies, other, Sexual Health

Erectile dysfunction (ED), also called impotence, is a very common sex problem. It occurs when you can’t achieve an erection or keep the erection firm enough to have sexual intercourse. Experts estimate that about one in three men experiences ED at some point in their life. This condition becomes more common with age, although it can also affect younger men.

There are many effective treatment options for ED. This condition can be successfully reversed in more than 19 out of 20 men. Which treatment options work best may depend on ED’s underlying causes, as well as your own needs and preferences.

Addressing Common Causes of ED

Erectile dysfunction is often caused by changes to your hormones, vascular system (heart and blood vessels), nervous system, or mental health. If you are experiencing ED, your doctor may want to perform a general health check-up to see whether it might be caused by another factor, such as an underlying health condition or medication.

Disorders That Could Cause ED

When ED occurs, it could be a sign that something else is going on with your health. For example, one common cause of ED is diabetes. Men with diabetes are three times more likely to develop erectile dysfunction, compared to men without diabetes. If you experience ED along with other diabetes symptoms, such as frequent urination, extreme thirst or hunger, or unexpected weight loss, tell your doctor. Diabetes can be managed with proper diet, exercise, or medication.

Erectile dysfunction may also be caused by:

Hypertension (high blood pressure)
Heart disease
Atherosclerosis (a condition in which plaque builds up in the arteries, hardening them and blocking blood flow)
Kidney disease
Peyronie’s disease
Multiple sclerosis (MS)
Parkinson’s disease
Damage to the penis, prostate, bladder, or spinal cord

ED can also develop after certain cancer treatments. Surgery for prostate cancer or bladder cancer can cause the condition. Additionally, other prostate cancer treatments such as radiation therapy to the pelvis and androgen suppression therapy may lead to ED.

Treating an underlying disorder may help improve ED symptoms. It’s important to talk to your doctor if you start experiencing this condition.

Mental Health and ED

Some mental disorders or emotional factors can cause erectile dysfunction or make it worse. ED can be a symptom of both anxiety and depression. Feelings of guilt, fear, or low self-esteem surrounding your sexual performance can also cause ED. Finally, men are more likely to experience ED when they are stressed or tired.

Talking to a counselor, therapist, or another mental health professional can help with all of these issues. These health providers can teach you techniques to better manage stress, reduce anxiety or depression symptoms, or reframe your attitudes surrounding sex. For some men, counseling is the most effective ED treatment.

ED as a Medication Side Effect

Medications that can lead to ED include:

Medications to treat high blood pressure
Antidepressants
Antianxiety medications that slow down processes in the brain and body, such as tranquilizers or sedatives
Antihistamines
Ulcer medications
Medications that suppress appetite

If you develop ED after trying a new drug or switching medication doses, talk to your doctor. You may be able to try an alternative treatment plan that won’t cause this side effect. However, it’s important to not stop taking a drug without first talking to your doctor, as some medications shouldn’t be stopped abruptly.

Lifestyle Changes

Your daily habits and choices can sometimes create or exacerbate problems with ED. Making some or all of the following changes may help:

Quit smoking with the aid of nicotine products, prescription medications, or support programs
Reduce the amount of alcohol you consume, or quit drinking altogether
Stop using illicit drugs with the help of your doctor, a therapist, or an addiction treatment program
Get more physical activity throughout the day by going on a walk, doing some work around the house, or trying aerobic exercise or a strength training workout
Achieve and maintain a healthy weight

Oral Medications for ED

There are several drug options that can help treat ED. They include:

Viagra (sildenafil)
Cialis (tadalafil)
Levitra (vardenafil)
Stendra (avanafil)

These medications enhance natural processes in the body that cause erections. A chemical called nitric oxide is partially responsible for erections. It relaxes muscles within the penis and widens blood vessels, boosting blood flow.

Oral (taken by mouth) ED medications strengthen nitric oxide’s natural effects. They can make it easier for you to experience erection when you are sexually aroused.

Safety of Oral ED Medications

Sildenafil, tadalafil, vardenafil, and avanafil are generally safe to take for most men. However, men with certain conditions should avoid these medications. These drugs may not be safe if you:

Have heart disease
Have experienced a stroke
Have been diagnosed with very low or high blood pressure
Have diabetes that is not controlled with diet or medication
Have severe liver or kidney disease
Take nitrates (medications to treat heart conditions) such as Nitrostat (nitroglycerin) or Imdur (isosorbide mononitrate)
Use anticoagulants (medications that help thin the blood), including Coumadin (warfarin), Pradaxa (dabigatran), or Xarelto (rivaroxaban)
Take medications for high blood pressure or prostate enlargement, including alpha blockers like Cardura (doxazosin) or Minipress (prazosin)

Oral ED medications often don’t cause any major side effects. However, some men may experience certain health changes while using these drugs, including:

Headache
Stuffy nose
Flushed skin on the face, neck, or chest
Upset stomach
Blurry or blue-tinged vision
Back pain

If you are interested in using oral ED medications, ask your doctor about possible positive and negative effects. Your doctor can also help you understand whether you can take these medications safely based on your personal health history.

Which Medication Is Best?

Each of these ED medications may lead to slightly different side effects and last for different lengths of time. For example, sildenafil and vardenafil typically last four to five hours, avanafil’s effects continue for up to six hours, and tadalafil can last for 36 hours.

Doctors often first recommend sildenafil for erectile dysfunction because this drug was developed first and it has been studied the longest. However, you may find that you prefer a different medication based on its effects or financial costs. You may need to try more than one medication or adjust your medication dose before you find something that works well for you.

Testosterone Replacement Therapy

Testosterone is a sex hormone that plays a role in sexual development and fertility, and sexual function, including erections. The amount of testosterone in the body decreases with age, and can also drop due to changes in the brain, problems with the thyroid (a gland that makes hormones), testicular damage, or obesity. Low levels of testosterone are sometimes responsible for ED.

Low testosterone levels could also cause symptoms like:

Low sex drive
Sleeping problems
Low sperm count
Weight gain
Decreased muscle strength
Weaker bones
Psychological problems like depression or difficulties focusing

If your ED is caused by low testosterone levels, you may be able to try testosterone replacement therapy (TRT). This involves taking medications that contain laboratory-made testosterone in order to elevate hormone levels in the body. This medication may come in the form of a pill, patch, implant, patch, or injection.

TRT may come with some side effects, such as:

Infertility
Insomnia
Problems with urination
High cholesterol levels
Heart problems
Blood clots

TRT may interact with certain medications, and only works if ED is caused by certain factors, so talk to your doctor before trying this therapy.

Other Erectile Dysfunction Medications

A couple of other medication options besides pills may also help with ED. One option is Caverject (alprostadil), a drug that is injected into the penis. This medication encourages blood to flow into the penis, making it become erect. The injection usually leads to an erection within five to 20 minutes, and the erection typically lasts between 30 and 60 minutes.

Alprostadil can also be used as a urethral suppository — a small pellet placed into the opening of the penis with an applicator. This form of alprostadil generally causes an erection within 10 minutes and its effects also last 30 to 60 minutes.

Alprostadil can lead to side effects like bleeding or bruising at the injection site, pain or burning in the penis or surrounding tissues, headache, back pain, or vision changes. Before using alprostadil injections or suppositories, tell your doctor if you are taking blood-thinning medications or using drugs to treat high blood pressure, allergies, or a cold.

Medical Devices for Erectile Dysfunction

Another possible ED treatment is a vacuum device or penis pump. To use this device, you place a plastic tube around your penis and use a pump to draw air out, which causes more blood to flow into the area. After achieving an erection, you place a ring around the base of your penis to keep your blood, and your erection, in place.

Vacuum devices may cause bruising, or make your penis feel cold or numb. However, most men experience orgasm normally after using this device.

Surgical Procedures for ED

The above treatment options will work for most men. However, in some cases a man may choose to try surgical ED treatments.

In one type of surgery, a doctor can implant a device into the penis. This may be an inflatable device connected to a pump in the scrotum, or a flexible rod that allows a man to move his penis into the desired position.

Some cases of ED are caused by a blocked blood vessel that prevents blood from reaching the penis. In this case, the blood vessel may be able to be fixed with surgery.

Alternative Medications and Supplements

Companies make many “natural” medicines or supplements that they say can treat ED. Some of these products may help improve sexual function, while many come with some risks.

Some studies have identified natural herbs or supplements that could possibly help ED and appear to be safe when taken at recommended doses. These include:

L-arginine
Ginseng
Dehydroepiandrosterone (DHEA)
Propionyl-L-carnitine

Although these supplements are often labeled as “natural” and are available without a prescription, you should still tell your doctor if you choose to use them. Some of these herbs, like ginseng, are only known to be safe when men use them for the short term. Other supplements, like L-arginine, shouldn’t be combined with other ED medications like sildenafil.

Not all supplements are safe. The U.S. Food and Drug Administration (FDA) has identified hundreds of supplements that contain drug ingredients not listed on the label. These supplements can sometimes cause serious health problems.

Some online retailers also claim to sell “herbal” versions of common prescription ED medications. These supplements are often not legitimate and can contain harmful substances.

In order to minimize risks, only take medications that are recommended by your doctor. It’s also a good idea to avoid products that claim to work very fast, are sold as single doses or were advertised to you through unsolicited emails.

Buying Medications Online

There are many places online where you can buy ED treatments — both supplements and prescription medications. Unfortunately, many retailers run scams or sell counterfeit treatments.

Keep yourself safe by only buying treatments from reputable pharmacies, whether online or brick-and-mortar. Some good rules to follow include:

Avoid buying prescription medications from places that claim a prescription is not necessary.
Only purchase medications from online pharmacies that list a valid phone number for contact purposes and ask to speak with licensed pharmacist to ensure there is proper medication counseling available.
If the online pharmacy is outside the United States, ensure it is certified by Canadian International Pharmacy Association (CIPA) by clicking on its CIPA seal.
When you receive your medication in the mail, make sure that it contains the right drug and dose.

Which ED Treatment Is Best?

The therapy that is most effective for someone else may not be the one that is best for you. The ideal ED treatment plan depends on factors like what is causing your condition, how severe your ED is, and whether you have other health conditions that contribute to your ED.

Your doctor can help you understand which treatment might be best for you and the benefits and drawbacks of each option. They can also prescribe any medications that you may need. It can be pretty tough to bring up this topic with your doctor but initiating that conversation can be the key to curing your ED and improving your well-being. If you or your loved one is experiencing ED and you would like to discuss it with a doctor, please make an appointment with Dr. Connor.

Can CBD Relieve Menopause Symptoms?

by Brynna Connor MD | Aug 26, 2022 | anxiety, hormones, other, Sexual Health, vitamins

In an article in Giddy, Dr. Connor explains that although menopause is a natural part of life, the symptoms often cause women to seek treatment. Read this entire article to find out how CBD oil works in the body and if it can be beneficial toward eleviating menopausal symptoms. If you are being impacted by menopausal symptoms and would like to discuss this further with Dr. Connor, please make an appointment.

Post-Pill Amenorrhea Shouldn’t Be Ignored

by Brynna Connor MD | Apr 6, 2022 | hormones, other, Sexual Health

In an article in Giddy, Dr. Connor explains “After a woman stops the pill, it can take anywhere from one month to several months to resume a ‘normal’ cycle, but a woman should see her physician if her menstrual cycle does not resume after the third month after she has stopped the pill.” Read the entire article to learn more. If you are experiencing similar symptoms that concern you, make an appointment with Dr. Connor.